Active NPI
Larry Theodore Legg II, LCSW
- Clinical Social Worker
- Tampa, FL
National Provider Identifier
1609981430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW 5685
- Practice address
- 8019 N Himes Ave
Suite 311
Tampa, FL 33614-2712 - Phone
- (813) 965-2800
- Fax
- (813) 933-4265
- NPI assigned
- Aug 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW 5685 | FL | Primary |
Addresses
Primary practice location
8019 N Himes Ave
Suite 311
Tampa, FL 33614-2712
Mailing address
1820 Latelia CT
Trinity, FL 34655-4907
Phone (813) 965-2800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW 5685 | FL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Community Healthcare Group Inc | Current | Accepting new patients | |
| Premier Community Healthcare Group, Inc. | Current | Accepting new patients |
Locations
14027 5th St
Dade City, FL 33525
Phone (813) 782-6064
Networks
- Freedom Health HMO Network
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Federally Qualified Health Center (FQHC)
- Dade City, FL
- NPI 1841263399
-
- Community/Behavioral Health Agency
- Tampa, FL
- NPI 1265619746
-
- Federally Qualified Health Center (FQHC)
- Zephyrhills, FL
- NPI 1508445362
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201392000000",
"number": "1609981430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1820 LATELIA CT",
"city": "TRINITY",
"state": "FL",
"postal_code": "346554907",
"telephone_number": "813-965-2800",
"fax_number": "813-933-4265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8019 N HIMES AVE",
"address_2": "SUITE 311",
"city": "TAMPA",
"state": "FL",
"postal_code": "336142712",
"telephone_number": "813-965-2800",
"fax_number": "813-933-4265"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEGG",
"first_name": "LARRY",
"middle_name": "THEODORE",
"name_prefix": "Mr.",
"name_suffix": "II",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-20",
"last_updated": "2008-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW 5685",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.